Country Energy - Residential Quote Request

Switching to Country Energy may save you money. Complete the form below and one of our representatives will be in touch with you as soon as possible. This form will only take a few minutes to complete – but you will need a copy of your latest bill so you can provide your consumption details.

*Required information

Title:

* First Name:

Last Name:

Phone:

Email:

Preferred method of contact:

Street:

City/Suburb:

Postcode:

State:

Street:

City/Suburb:

Postcode:

State:

National Metering Identifier:

Existing
New

To provide you with a quote we need to know your consumption details and how you currently purchase your electricity. This information can be found on the back of your account.

Please enter the details that applies to you:

Domestic or general supply tariff (kWh)

Off Peak 1 (kWh)

Off Peak 2 (kWh)

Number of days for this account?

or

Time of use tariffs:

Peak (kWh)

Shoulder (kWh)

Off Peak (kWh)

Demand component in kW or kVA
Number of days for this account?

By signing up to countrygreen®, you can choose to have a percentage of your energy sourced from renewable sources from an additional $1.00 per week including GST.

Domestic or Rural Customers

Product *	Price (incl. GST)	Accreditation	GreenPower kWh's	Please select
foreverGREEN	$6.00 extra per week	100%	6,470 kWh's	Yes
livingGREEN	$3.85 extra per week	50%	3,235 kWh's	Yes
liteGREEN	$1.85 extra per week	20%	1,294 kwh	Yes
everydayGREEN	$1.00 extra per week	10%	647 kWh's	Yes

e.g. I require a quote for green energy or would like information on energy efficiency.

Concerned about Privacy? Please be aware Country Energy will only use this information for the purposes outlined on this page. For more information on Privacy, please refer to our Privacy Policy.

Personal details

Title:

* First Name:

Last Name:

Phone:

Email:

Preferred method of contact:

Postal address

Street:

City/Suburb:

Postcode:

State:

Service Address

Street:

City/Suburb:

Postcode:

State:

OR NMI

National Metering Identifier:

Is this an existing or a new address?

Consumption

Please enter the details that applies to you:

or

Time of use tariffs:

Who is your current electricity retailer?

Please tick if you are interested in any of our countrygreen® options, listed below:

Domestic or Rural Customers

Any comments/questions?

e.g. I require a quote for green energy or would like information on energy efficiency.